A Mixed-Methods Pilot Study of Mindfulness-Based Stress Reduction for HIV-Associated Chronic Pain

ABSTRACT

Treatment guidelines for chronic pain recommend nonpharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of nonpharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness-Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no effect of group assignment was observed. At 3-month follow-up, 79% of MBSR participants were still practicing, and pain intensity was improved, whereas in the control group pain intensity had worsened. Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief.

Keywords:

• chronic pain
• HIV
• Mindfulness-Based Stress Reduction (MBSR)
• mixed methods

Acknowledgments

The authors thank Dr Monica Rivera Mindt and Vanessa Guzman for their contributions which include critical review of the statistical analyses and manuscript. Figure production was aided by Daniel'sXL Toolbox addin for Excel, version 6.53, by Daniel Kraus, Würzburg, Germany.

Funding

This work was supported by a grant (K23 NS066789) from the National Institute of Neurological Disorders and Stroke to Dr Robinson-Papp, and the CTSA grant (UL1 TR000067) awarded to the Mount Sinai School of Medicine.